No abstract available.
Candidiasis* ; Humans ; Infant, Newborn ; Infant, Premature*

To know testicular growth and operative results after orchiopexy in unilateral cryptorchidism a retrospective study was performed on 56 patients at least 8 months after orchiopexy due to unilateral cryptorchidism by palpation of testis, inspection of operation scar, evaluating testis volume using Prader orchidometer, and interviewing with the patients and their parents about previous undescended testis. Their medical records were also reviewed. Patients' mean age at orchiopexy was 6 years and 8 months. Mean duration after orchiopexy was 3 years and 7 months at the time of followup. Inguinal orchiopexy was performed in all patients except one. Operative success was defined as scrotal position of previous undescended testis without atrophy Testis volume ratio was defined as T2/T1 (T1=volume of previous undescended testis, T2= volume of contralateral descended testis). Mean testicular volume was 3.66+/-3.12ml in previous undescended testis and 5.11+/-5.42ml in contralateral descended testis, respectively(p>0.05.) In patients with public hair mean testicular volume was 8.76+/-2.30ml in previous undescended testis and 13.5+/-4.80ml in contralateral descended testis, respectively(p<0.01). Testis volume ratio had moderate correlation with age at orchiopexy and age at followup(r=0.44, 0.46, respectively). Operative success rate was 88%. Of 47 parents who accompanied by patients 32 were satisfied, 7 were intermediate, 8 were unsatisfied with previous undescended testis associated with size, position, and/or consistency. Inguinal operation scar was cosmetically better in transverse skin incision than in oblique skin incision(p<0.01). Moderate correlation of testis volume ratio with age at orchiopexy might suggest that early orchiopexy enhances catch-up growth of previous undescended testis. Moderate correlation of testis volume ratio with age at followup and significant difference of mean testicular volume between previous undescended testis and contralateral undescended testis in patients with public airs, might imply that growth of previous undescended testis become retarded comparing to that of contralateral descended testis at puberty which is critical period for testicular growth. These should be confirmed via prospective long-term studies which include early orchiopexy and more accurate measurement of testis volume using ultrasonography. Appropriate surgical treatment of cryptorchidism needs various orchiopexy techniques and proper selection of surgical options including orchiectomy.
Adolescent ; Atrophy ; Cicatrix ; Critical Period (Psychology) ; Cryptorchidism* ; Follow-Up Studies ; Hair ; Humans ; Male ; Medical Records ; Orchiectomy ; Orchiopexy* ; Palpation ; Parents ; Puberty ; Retrospective Studies ; Skin ; Testis ; Ultrasonography

No abstract available.
Allopurinol* ; Alprostadil* ; Skin*

A collodion baby is born with a tough, inelastic parchment-like membrane covering the whole body surface. As the meinbrane fissures and peels, a more characteristic ichthyosiform change is evident beneath the collodion membrane. Uncommonly, normal skin is found under it. We herein present two cases af collodion baby, which were confirmed as a sporadic case of lamellar ichthyosis and a case of lamellar exfoliation of the newborn, respectively, after long-term clinical observation. It is necessary that detailed genetical and molecular biological studies should be perforrned in order to elucidate the fur:damental, molecular changes that cause these dramatic cutaneous changes.
Collodion* ; Humans ; Ichthyosis, Lamellar ; Infant, Newborn ; Membranes ; Skin

PURPOSE: To evaluate the indication for intracavitary Urokinase(UK) in the treatment of Ioculated pleural effusion. MATERIALS AND METHODS: We analyzed CT and US in 31 patients who were treated with intracavitary UK in Ioculated pleural effusion. In each patient, a single chest catheter (10-12F) was insected under imaging guidance. When the amount of drainage was less than 100ml/day, UK was instilled through the catheter until less than 50ml/day was drained. On follow-up chest radiographs of more than 1 month, we classified the results of treatment into 3 groups:(1) completely effective (lung expansion, over 80%);(2) partially effective (20-80%); (3) ineffective (below 20%) group. Sonographic pattern of pleural fluid was classified into anechoic, septated, and honeycomb appearances and the thickness of parietal pleura was measured on CT. RESULTS: Sixteen patients were completely effective, nine were partially effective, and six were ineffective. patients with completely or partially effective outcome had anechoic and linear septated appearance on had less than 4mm of parietal pleural thickness on CT. Of six ineffective patients, US showed linear septated in one patient and honeycomb appearance in five patients and the thickness of parietal pleura on CT was 3 mm in one patient, 4ram in two patients, 5mm in one patient, and 6mm in two patients. CONCLUSION: UK instillation through percutaneous catheter was an effective method in the treatment of Ioculated pleural effusion. However, we found near complete reaccumulation of pleural fluid when honeycomb appearance of pleural fluid on US or more than 5mm parietal pleural thickness on CT was observed, which might suggest that we should consider the other kinds of treatment method in those patients.
Catheters ; Drainage ; Follow-Up Studies ; Humans ; Insects ; Pleura ; Pleural Effusion* ; Rabeprazole ; Radiography, Thoracic ; Thorax ; Ultrasonography ; Urokinase-Type Plasminogen Activator*

It is known that TGF-beta induces scar in fetal wound healing. The fact gives us that inhibition of TGF-beta can reduce scar formation. It has been reported that neutralizing antibody of TGF-beta reduced scar in rat incisional wounds. Meanwhile decorin, which is main proteoglycan of extracellular matrix, has been known as other antagonist against TGF-beta. However there has been no report about effects of decorin on scar formation. This study examined the histologic findings and width of incisional wound of rat, which was treated with decorin, compsring with non treated wound. We found that scar width was narrower in wounds 2 and 8 weeks after incision and the amount of collagen fiber is less in wounds treated with decorin than in control group. The collagen fibers, especially in wound 8 weeks after incision, were thick and regularly arranged and similar to no dermis in wounds treated with decorin. These results suggest that decorin reduces scar formation and facilitates maturation in wound healing. Even though this study cannot confirm its mechanism, the effect of decorin might be due to inhibition of TGF-beta.
Animals ; Antibodies, Neutralizing ; Cicatrix ; Collagen ; Decorin* ; Dermis ; Extracellular Matrix ; Proteoglycans ; Rats* ; Transforming Growth Factor beta* ; Wound Healing* ; Wounds and Injuries*

Cleft lip is one of the most common congenital deformities in craniofacial region. However, despite many reports on the outcome of various surgical techniques from individual medical centers, the evaluation of the outcome has been based on the subjective observation. Therefore, developing a new technique of objective and scientific evaluation for the nasal deformity of secondary cleft lip and nasal deformity is important to improve the management of the cleft lip patients. The authors have proposed a new scoring model to evaluate objectively the nasal deformity. The authors put 'x' axis on the nostril sill of noncleft side and 'y' axis on nasal tip at a right angle to x axis. The nostril of noncleft side was turned around the y axis to form the mirror image on the cleft side, and following four parameters were recorded: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) the overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. The post-surgery images were evaluated by the three plastic surgeons, using the scale of 5 percentiles. The four parameters of each image were measured using a newly developed software and correlation coefficients of each parameter and the evaluation scale by the surgeons were obtained. Among the scores from scoring model, errors greater than 10 percents were found only in 2 of 14 cases (2/14=14%), but among the scores from examiners, errors of greater than 10 percents were 4 from 14 cases (4/14=29%). Based on the results, deviation among the individual examiners can be reduced using the objective evaluation program developed in this study. The correlation coefficients between the normalized overlap area (0.78) and the distance between the centers of two nostrils (-0.82) with the evaluated scale by surgeons were high. However, the relative area and the degree difference of two nostril axis were found to be not such a good parameters in the evaluation of the nasal deformity. We developed scoring model from analysis of nostril shape and neural network which is able to evaluate cleft lip nasal deformity objectively after selection of proper parameters.
Axis, Cervical Vertebra ; Cleft Lip* ; Congenital Abnormalities* ; Humans ; Nose*

OBJECTIVES: This study was conducted to investigate whether air pollution levels in Seoul have short term effects on respiratory disease outpatients. METHODS: We analyzed five air pollutants (CO, NOy, Oy, SOp, PMyp) and daily counts of outpatient for respiratory disease divided by age group ((15yrs, 15-64yrs, 65+yrs) during the period of July 1997-June 1998 using Generalized Additive Model(GAM). RESULTS: After controlling for seasonal trends, day of the week, week of the month, temperature and humidity, CO (RR=1. 041 ~ l. 051, 0-day lag) and NOy (RR=1. 024~1. 050, 3-day lag) were significantly associated with daily counts for respiratory disease in all age groups. 0, and SO, were associated, with a 3-day lag in the age group under 15 years (O RR=1. 047, 95% CI=1. 045- 1. 049 i SOp RR=1. 018, 95% CI=1. 017- l. 020) and with a 0-day lag in the age group 15 to 64 years (0, RR=1. 035, 95% CI=1. 032-1. 037; SO, RR=1. 037, 95% CI=1. 035-1. 039), in the age group over 65 years (O RR=1. 042, 95% CI=1. 033-1. 051; SO RR=1.029, 95% CI=1.022-1.036). PM was weakly associated, with a 1-day lag in the age group under 15 years (RR=1.011, 95% CI=1.010-1.013) and with a 0-day lag in the age group 15 to 64 years (RR=1. 021, 95% CI=1. 019-1. 023), in the age group over 65 years (RR=1. 025, 95% CI=1. 018-1. 032). In the two pollutant model, the magnitudes of the relative risk for CO, NOy and Oq were maintained, but SOy was not associated with daily counts for respiratory disease in the age group under 15 years after controlling for NO,. PMyp was not associated in all age groups after controlling for CO, so the association with PMyp in the single pollutant model might be confounded by CO. In this study, the impact Of PMyp on the respiratory disease was not large as compared with other pollutants. CONCLUSIONS: Air pollution in Seoul may increase the incidence of the respiratory disease, so more positive attention for the control of air pollution should be paid.
Air Pollutants* ; Air Pollution ; Humans ; Humidity ; Incidence ; Outpatients* ; Seasons ; Seoul*

The treatment of massive bone and soft tissue defect in the lower leg has a high complication rate of nonunion, chronic infection, and amputation without well-vascularized tissue coverage of the open fracture. Despite adequate free soft tissue coverage, massive skeletal defect may result in segmental bone defects, angulation deformity, and limb length discrepancies. In the last decade, major advances have occurred in the Ilizarov method of distraction osteogenesis in lower leg salvage as a delayed procedure or simultaneous distraction after free-tissue transfer. The authors have performed Ilizarov transport in conjunction with muscle and musculocutaneous flap coverage in nine cases of lower leg salvage. The flaps consist of rectus, gracilis, latissimus dorsi, parascapular, and serratus muscle or musculocutaneous fashioning using ipsilateral or contralateral pedicle in consideration of vessel condiation. Revision, recorticotomy and flap elevation were also used as a secondary procedure for satisfactory results. The conclusions, were as follows: 1) Multidisciplinary team approach with conjoining departments at the time of preoperative evaluation, postoperative care and rehabilitation care; 2) Muscle flap covered with split-thickness skin graft was preferred to musculocutaneous flap; 3) To reduce the total reconstructive period, simultaneous free tissue transfer with Ilizarov distraction should be considered.
Amputation ; Congenital Abnormalities ; Extremities ; Fractures, Open ; Ilizarov Technique ; Leg* ; Myocutaneous Flap ; Osteogenesis* ; Osteogenesis, Distraction ; Postoperative Care ; Rehabilitation ; Skin ; Superficial Back Muscles ; Transplants

PURPOSE: To evaluate the value and the radiologic findings of CT discography in the diagnosis of the far lateral disk herniation. MATERIALS AND METHODS: We retrospectively reviewed 7 cases of surgically proven far lateral lumbar disc herniation. CT discography was performed for all cases. Four cases underwent conventional CT and three cases MRI as a primary diagnostic imaging method. Far lateral diac herniation was divided into 3 groups by location;Intraforaminal herniation, extraforaminal herniation, and mixed type. We analyzed the findings of CT discography including location and extent of far lateral disc herniation. RESULTS: In all 7 cases, CT discography clearly demonstrated the filling of contrast media in laterally-protruded disc material. Intraforaminal and extraforminal types were seen in 2 cases each, and mixed type in 3 cases. Subligamentous herniated nucleus pulposus was present in 6 cases and extruded disc in 1 case. Far lateral disc herniation was located at L4-5 in 5 cases and L5-S1 in 2 cases. CONCLUSION: CT discography can help establishing accurate preoperative diagnosis for far lateral disc herniation.
Contrast Media ; Diagnosis ; Diagnostic Imaging ; Magnetic Resonance Imaging ; Retrospective Studies